DIAGNOSTIC EFFICACY OF DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING IN THYROID LESIONS

Abstract

Background: Thyroid nodules, prevalent in up to 76% of populations, pose a diagnosticchallenge due to the potential for malignancy. Conventional imaging techniques, likeultrasound and computed tomography, often lack accuracy. Diffusion-weighted magneticresonance imaging (DW-MRI) has emerged as a promising tool for thyroid lesion assessment.By measuring apparent diffusion coefficient (ADC) values, DW-MRI offers insights intotissue microstructure, aiding in distinguishing between benign and malignant nodules.Despite challenges, integrating DW-MRI into clinical practice promises improved diagnosticaccuracy and personalized treatment planning.Methods: This prospective cross-sectional study assessed diffusion-weighted MRI (DWMRI) in thyroid lesion characterization. Patients with nodules detected on ultrasoundunderwent DW-MRI and histopathological confirmation. Imaging utilized a 1.5 Tesla MRIscanner with multi-b-value imaging. Two radiologists independently reviewed images,calculating apparent diffusion coefficient (ADC) values. Histopathology involved FNAB orsurgical excision. Statistical analysis determined diagnostic metrics and optimal ADCthresholds for malignancy prediction using SPSS version 20.0.Results: Our study enrolled 69 patients with thyroid nodules, with a mean age of 39.2 ± 15.3years. DW-MRI exhibited high diagnostic accuracy in distinguishing benign (n=43) frommalignant (n=26) thyroid nodules. Sensitivity was 91.30%, specificity 89.13%, positivelikelihood ratio 8.40, negative likelihood ratio 0.10, positive predictive value 80.77%,negative predictive value 95.35%, and accuracy 89.86%. ROC analysis revealed an areaunder the curve of 0.934 (p<0.0001), indicating DW-MRI's robust discriminatory capability.Concordance between DW-MRI diagnosis and histopathological results was significant(p<0.001).Conclusion: DW-MRI demonstrates high accuracy in differentiating benign from malignantthyroid nodules. Its robust diagnostic performance, evidenced by sensitivity, specificity, andROC analysis, underscores its potential as a valuable adjunct to conventional imagingmodalities. Implementation of DW-MRI could enhance clinical decision-making and reduceunnecessary invasive procedures for thyroid lesion evaluation.